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. 2023 Jul 20;189(1):K1-K6.
doi: 10.1093/ejendo/lvad093.

Etiology, morphology, and outcomes of adrenal calcifications in 540 adult patients-a retrospective single-center study

Annop Kittithaworn  1 , Prerna Dogra  1 , Leili Rahimi  1 , Rashi Sandooja  1 , Irina Bancos  1
Affiliations

Etiology, morphology, and outcomes of adrenal calcifications in 540 adult patients-a retrospective single-center study

Annop Kittithaworn et al. Eur J Endocrinol. .

Abstract

Sparse data are available on the etiology, morphology, clinical presentation, and outcomes of adrenal calcification. In this single-center retrospective study of 540 consecutive patients (median age 65 years, 45% women) with adrenal calcification on computed tomography (December 2017 to January 2021), most were discovered incidentally (472, 87%). The commonest etiology was idiopathic (389, 72%), followed by the adrenal tumor (113, 21%), hemorrhage (29, 5%), and infiltrative disease (7, 1%). Calcified adrenal tumors were predominantly benign (92, 81%) and primarily adenomas (63, 69%), whereas the most common calcified adrenal malignancy (16, 18%) was metastasis (12, 67%). Calcification (unilateral 94%, bilateral 6%) morphology varied from punctate (313, 58%) to coarse (165, 30%), linear/curvilinear (46, 9%), and rim-like (16, 3%). In summary, adrenal calcifications are usually incidentally discovered unilateral, punctate, or coarse lesions of unclear etiology. Most calcified adrenal tumors are benign and <20% malignant or pheochromocytomas.

Keywords: adrenal mass; adrenal tumor; calcified; computed tomography; primary adrenal insufficiency.

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Conflict of interest statement

Conflict of interest: I.B. serves on the editorial board for EJE and was not involved in the handling of this manuscript. I.B. reports consulting (fee to institution) from HRA Pharma, Recordati, Corcept, Sparrow, Neurocrine, Diurnal, Adrenas, and Spruce, outside this work. I.B. reports funding for the investigator-initiated award from Recordati (outside this work). Other authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Schematic presentation of adrenal calcification morphologies and location.
Figure 2.
Figure 2.
Adrenal (gland and tumor) calcification illustration on computed tomography imaging. (A) Punctate calcification in the right adrenal gland. (B) Punctate calcifications in the left adrenal gland. (C) Coarse calcification in the right adrenal gland. (D) Coarse calcifications of the bilateral adrenal glands. (E) Linear calcification in the right adrenal gland. (F) Curvilinear peripheral calcifications associated with the right adrenal cyst. (G) Rim-like (eggshell) calcification associated with the left adrenal cyst. (H) Punctate peripheral calcifications associated with the left adrenal adenoma. (I) Punctate central calcifications associated with the left adrenal adenoma. (J) Coarse central calcification associated with the left adrenal pheochromocytoma. (K) Punctate and linear septal calcifications associated with the right adrenal teratoma. (L) Coarse central and curvilinear peripheral calcification associated with the right adrenal cyst.
See this image and copyright information in PMC

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